新生兒臍動脈插管深度的研究

A Study of Insertional Length of Umbilical Artery Catheters in Newborns

鄭俊智(Jiunn-Jue Jeng) ； 高信安(Hsin-An Kao) ； 江滄鎮(Chang-Jen Jiang) ； 郭浩然(How-Ran Guo)

《Acta Paediatrica Sinica》 30卷2期 (1989/04) Pp. 100-104

摘要

為了預估新生兒臍動脈導管內管深度的適當值，我們進行兩部份的研究。第一部份以病例追蹤方式測試四組公式之準確度，這四組公式是①3×birth weight (BW) (Kg)+9(cm)②suprasternal notch to pubic symphysis length (SSL) (cm) ③三分之一×total body length (TBL) (cm)④shoulder to umbilicus length (SUL) (cm)+2(cm)。從民國75年12月至民國76年11月一年間，由馬偕紀念醫院新生兒加護中心收集一百二十個病例，依入院順序隨意編成四組，分別使用前述四組公式預估新生兒臍動脈導管內管深度。結果顯示BW和TBL組有相同準確度(90%), SUL和SSL組也有相同準確度(70%)，各組間準確度無統計上差異，但臨床應用則以BW及TBL公式較方便。第二部份以病例回顧方式收集第一部份研究中臍動脈導管尖端置於第七至第九胸椎間之病例，共得六十三例appropriate for gestational age (AGA)病例進行相關係數之線性廻歸的統計分析。結果顯示臍動脈導管內管深度和四個參數（BW、SSL、 TBL及SUL）的相關係數有統計上的意義，但各相關係數間彼此無統計上相差；進一步研究線性廻歸，可推演出四組公式，分別是①7×BW(kg)+2(cm)②SSL(cm)③三分之一×TBL(cm)+0.5(cm)④SUL(cm)+1(cm)。small for gestational age (SGA)和large for gestational age (LGA)病例因數目太少，無法進行統計分析，有待以彼進一步研究。

並列摘要

To correlate the neonatal body measurements that best preidct insertional length of the umbilical artery catheter (UAC), we performed this study with two separate parts.
In part Ⅰ, we collected 120 cases with indication for umbilical artery catheterization from Mackay Memorial Hospital during December 1986 to November 1987. They were randomly divided into 4 groups and in each group the internal catheter length of UAC was calculated with formula of: Gr. 1.3 birth weight (BW) (Kg) + 9(cm), Gr. 2. suprasternal notch to public symphysis length (SSL) (cm), Gr. 3.1/3 total body length (TBL) (cm), Gr. 4. shoulder to umbilicus length (SUL) + 2(cm). The accuracy was 90% in BW group, 90% in TBL group, 70% in SSL group and 70% in SUL group respectively, and there was no statistical difference between any two groups. However, BW and TBL formula were clinically more pratical than the other two (SUL and SSL).
In part Ⅱ of our study, out of 120 cases we selected 63 appropriate for gestational age (AGA) cases with catheter tips placed between the 7th and 9th thoracic vertebra. Correlation coefficients (rs) between inserted length of UAC and each of the four parameter (BW, TBL, SSL, and SUL) were shown to have statistically significant correlation. There was no statistical difference among those correlation coefficients. Modified regression equations derived from BW, SSL, TBL and SUL were 1.7BW (kg) + 2(cm). 2. SSL(cm). 3.1/3 TBL(cm) + 0.5(cm). 4. SUL (cm) + 1(cm). Further study would be necessary for establishing a more widely adaptable equation.

並列關鍵字

umbilical artery catheter ； birth weigh ； suprasternal notch-pubic symphysis length ； total body length ； shoulder to umbilicus length